Isolation Guidelines


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  • Staphylococcus Aureus Resistant to Methicillin (MRSA)

    Isolation requirements

    • Disease: Staphylococcus aureus resistant to methicillin, oxacillin or nafcillin (MRSA)
    • Category: Contact Precautions; add Droplet Precautions for individuals with positive cultures of sputum and productive cough or those undergoing cough inducing procedures. Droplet Precautions not required for asymptomatic nasal carriers.
    • Placement: Patients known to be infected or colonized with MRSA shall NOT be placed in rooms adjacent to patients with vancomycin resistant enterococci (VRE).
    • Infective material: Infection at any site implies diffuse skin colonization.
    • Duration of isolation: Once a patient is flagged as being placed in Contact Precautions by this protocal, the patient will remain in isolation for all subsequent admissions. Patients may only be removed from Contact Precautions by the hospital infection prevention physician or his designee.
    • Discontinuation of isolation: Patients effected with MRSA may be removed from isolation if they meet the following criteria (and then only by the hospital epidemiologist or his designee):
      • The patient has had no positive cultures for MRSA from any site in the previous three months. 
      • If the patient has received no antibacterial medication for the past 72 hours, surveillance cultures must performed daily for three different calendar days from all following sites:
        • Nasal wwabs
        • Wounds
        • Indwelling devices such as tracheostomy, gastrostomy, etc.
        • Any other source that has cultured MRSA positive in the past.
      • If all cultures are negative for MRSA, the patient may be removed from Contact Precautions by the hospital epidemiologist or his designee.
      • Contact infection control at 4-2188 prior to discontinuation of isolation.
    • Comments: See MRSA Information Sheet for information on management of patients in isolation. See also MRSA Information Sheet for Patients and Families.